骨盤部悪性腫瘍に対するHip transposition法を施行された患者の社会復帰

Reintegration of patients undergoing hip transposition for malignant pelvic tumors: A case study

要旨：骨盤部悪性腫瘍に対し，創外固定術を併用したHip transposition法が施行された，10歳代女性の作業療法を経験した．術前評価では，すでに進学が決定しており，復学に対する不安がみられた．早期よりトイレ動作訓練を中心に行い，術後19日で便座での排泄が可能となった．創外固定器抜去後は，更衣・入浴動作訓練を中心に行った．術後75日で一時自宅退院となり，1年後の復学までの間に自動車免許を取得し，自家用車での通学も可能となった．今回，退院後も作業療法を継続し，様々な場面を想定したアプローチを行った．その結果，目標としていた復学が可能となり，社会復帰を見据えた作業療法の長期的な関わりの重要性が示唆された．

　We carried out occupational therapy on a woman in her teens who underwent hip transposition arthroplasty following resection of pelvic sarcoma combined with temporally external fixation. At the time of diagnosis, she was supposed to go to university, and in the preoperative evaluation, she felt anxious about returning to school. The occupational therapy focused on toilet movement training before removal of the external fixation, and she was able to excrete using a toilet seat 19 days after surgery. After removal of the external fixation, we focused on changing clothes and bathing exercises. 75 days after the operation she was discharged to her home. She was able to get her driver's license and drive herself to school one year after the treatment. The results indicate the importance of preoperative occupational therapy on the targeted recovery.